| NPI | 1508842261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: NY 020469) |
| Additional Taxonomies | 173000000X Legal Medicine |
| 174400000X Specialist (Licence: NY 020469) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2014-12-05 |